Role of carnitine in disease Nutrition & Metabolism Springer Nature Link Translating the basic knowledge of mitochondrial functions to metabolic therapy: role of L carnitine ScienceDirect L carnitine is primarily synthesized in the liver from the amino acids lysine and methionine through a series of four enzymatic reactions, with the liver and kidneys converting the precursor butyrobetaine into active PDF) The Role of l Carnitine in Mitochondria, Prevention of Metabolic Inflexibility and Disease Initiation